Incidence of diagnosed clinical otosclerosis.
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Malleus fixation, in addition to stapes fixation, presents a perplexing surgical problem. Should the incus replacement prosthesis procedure be performed or only a stapedectomy? The hearing results of a stapedectomy alone in 45 cases with both stapes and malleus fixation are 70% within 10 dB and 84% within 20 dB of the preoperative bone conduction hearing level.
Controversy exists regarding the appropriateness of offering all residents training in stapes surgery due to dwindling case loads in residency programs nationally. A recent study indicated poorer results for stapes surgery performed by residents than results obtained by practicing otologists. One hundred consecutive stapedectomies performed by residents over a three-year period at our institution were reviewed retrospectively, with the objective of determining whether these results should be generalized.
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More than 3000 workers referred by the Workmen's Compensation Board of Ontario have been evaluated for pension for industrial hearing loss. They include the normal proportion of otosclerotics, many of whom have had surgical therapy. The operations have been done by a wide variety of surgeons in the province of Ontario, and the results are representative of those which will be obtained in a large section of the Canadian community. The results are significantly worse than generally quoted, and some of the deficiencies are attributable to occupation. These include perilymph fistula from excessive straining and sensorineural hearing loss due to noise exposure. Detailed results will be presented.
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